不同剂量皮质类固醇早期应用对挫伤性前房积血预后影响的前瞻性研究  

Prospective study on application dosage of corticosteroid hormone in traumatic hyphema

作　　者：计青[1] 杨波[1] 樊利敏[1] 

机构地区：[1]广东省深圳市沙井人民医院眼科,广东深圳518000

出　　处：《临床和实验医学杂志》2013年第10期740-741,744,共3页Journal of Clinical and Experimental Medicine

基　　金：广东省深圳市宝安区科技计划社会公益科研资助项目;项目编号:2009343。项目名称:皮质类固醇应用时间对挫伤性前房积血预后的前瞻性研究

摘　　要：目的探讨不同剂量皮质类固醇早期应用对挫伤性前房积血预后的影响。方法选择眼科2010年12月至2012年12月住院治疗的60例挫伤性前房积血患者为研究对象。运用随机数字表法将挫伤性前房积血患者分为两组,即A组和B组,各30例,两组患儿均给予地塞米松治疗,两组患者除使用的地塞米松剂量不同外其他治疗措施完全相同,A组患者给予10 mg/(kg.d)地塞米松治疗,B组患者则给予15 mg/(kg.d)地塞米松治疗,比较两组患者前房积血吸收时间、出院时视力、高眼压发生率、继发性前房出血发生率和药物不良反应发生率。结果 B组患者前房积血吸收时间均明显短于A组患者的(P<0.05),B组患者治疗有效率明显高于A组患者的(P<0.05),两组患者在继发性高眼压、血压升高和面部痤疮发生率差异有统计学意义(P<0.05)。结论 15mg/(kg.d)地塞米松治疗挫伤性前房积血临床疗效确切,疗效优于10 mg/(kg.d)地塞米松,但是,大剂量地塞米松的使用明显增加了药物不良反应的发生,为此,在对患者进行临床治疗的过程中,要权衡利弊,根据患者的实际情况选择地塞米松的使用剂量。Objective To investigate application dosage of corticostereid hormone in traumatic hyphema. Methods Sixty traumatic hyphema patients who were treated in the ophthalmology department of our hospital from December 2010 to December 2012 were divided into group A （n =30） and group B （ n =30）. Patients in group A were given 10 mg/（kg · d） dexamethasone, but patients in group B were given 15 mg/ （ kg · d） dexamethasone. The other treatments of patients in two groups were the same. The anterior chamber hemorrhage absorption time, hospital vision, the incidence of intraocular hypertension, secondary intraocular hemorrhage rate and adverse drug reaction rate were compared between two groups. Results The anterior chamber hemorrhage absorption time in group B were less than that in group A （ P 〈 0. 05 ）. The treatment efficiency in group B were higher than that in group A （ P 〈 0. 05 ）. There were significant differences in the occurrence rate of secondary high intraocular pressure, raised blood pressure and facial ache （all P 〈 0.05 ）. Conclusion The effect of 15 mg/（ kg · d） dexamethasone is superior to 10 rag/ （kg · d） dexamethasone for the treatment of traumatic hyphema, but the large dose of dexamethasone dramatically increases the occurrence of adverse drug reactions. Therefore, in clinical treatment process, we must weigh the pros and cons to choose dexamethasone dosage according to the actual situation of the patients.

关 键 词：挫伤性前房积血 地塞米松 剂量 

分 类 号：R779.1[医药卫生—眼科]